title: Leisure-time aerobic physical activity, muscle-strengthening activity and mortality risks among US adults: the NHANES linked mortality study.
abstract: BACKGROUND
  Regular physical activity elicits multiple health benefits in the prevention and management of chronic diseases. We examined the mortality risks associated with levels of leisure-time aerobic physical activity and muscle-strengthening activity based on the 2008 Physical Activity Guidelines for Americans among US adults.
  
  
  METHODS
  We analysed data from the 1999 to 2004 National Health and Nutrition Examination Survey with linked mortality data obtained through 2006. Cox proportional HRs with 95% CIs were estimated to assess risks for all-causes and cardiovascular disease (CVD) mortality associated with aerobic physical activity and muscle-strengthening activity.
  
  
  RESULTS
  Of 10 535 participants, 665 died (233 deaths from CVD) during an average of 4.8-year follow-up. Compared with participants who were physically inactive, the adjusted HR for all-cause mortality was 0.64 (95% CI 0.52 to 0.79) among those who were physically active (engaging in ≥150 min/week of the equivalent moderate-intensity physical activity) and 0.72 (95% CI 0.54 to 0.97) among those who were insufficiently active (engaging in >0 to <150 min/week of the equivalent moderate-intensity physical activity). The adjusted HR for CVD mortality was 0.57 (95% CI 0.34 to 0.97) among participants who were insufficiently active and 0.69 (95% CI 0.43 to 1.12) among those who were physically active. Among adults who were insufficiently active, the adjusted HR for all-cause mortality was 44% lower by engaging in muscle-strengthening activity ≥2 times/week.
  
  
  CONCLUSIONS
  Engaging in aerobic physical activity ranging from insufficient activity to meeting the 2008 Guidelines reduces the risk of premature mortality among US adults. Engaging in muscle-strengthening activity ≥2 times/week may provide additional benefits among insufficiently active adults.
authors.affiliation: Division of Behavioral Surveillance, Office of Surveillance, Epidemiology and Laboratory Services, , Atlanta, Georgia, USA.
authors.forename: Guixiang
authors.initials: G
authors.lastname: Zhao
authors.forename: Chaoyang
authors.initials: C
authors.lastname: Li
authors.forename: Earl S
authors.initials: ES
authors.lastname: Ford
authors.forename: Janet E
authors.initials: JE
authors.lastname: Fulton
authors.forename: Susan A
authors.initials: SA
authors.lastname: Carlson
authors.forename: Catherine A
authors.initials: CA
authors.lastname: Okoro
authors.forename: Xiao Jun
authors.initials: XJ
authors.lastname: Wen
authors.forename: Lina S
authors.initials: LS
authors.lastname: Balluz
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease / Q000401:mortality*; D015444:Exercise / Q000502:physiology*; D005260:Female; D006801:Humans; D007899:Leisure Activities; D008297:Male; D061213:Mortality, Premature; D053580:Muscle Strength / Q000502:physiology*; D009749:Nutrition Surveys; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: Cardiovascular Epidemiology; Epidemiology; Exercise; Health Promotion Through Physical Activity